Laserfiche WebLink
/� E N I H A L I , Y <br />boa_ <br />Chain of, Custody Record <br />Lab No: 2 G '7 S� l <br />Page: of <br />Turn Around Time )rush by advanced notice only) <br />Standard: <br />5 <br />3 Day: <br />2 Day: <br />Custom TAT <br />aN/A <br />aN/A <br />Matrix: A= Air S = Soil/Solid W:= Water <br />DW = Drinking Water P = Product O= Oil <br />SD=Sediment T=Tissue WP=Wipe <br />WW = Wastewater %=Other <br />Sample Type: <br />C = Composite <br />6=Grab or Discrete <br />B=Blank O=Other <br />Preservat - Sample Receipt Temp and Notes: <br />1= Na25r03 2 = HCl 7 ? /3 •/ <br />3=HNOs 4-H,SO, ZR Cr tc ( <br />5=NaOH 6=Other (ma use oeh) <br />CUSTOMER INFORMATION <br />PROJECT INFORMATION <br />Analysis Request <br />Test Instructions / Comments <br />Company: <br />n _ `6Dc-'9te5 <br />Name l.G+�� - 11pus.-Gw for <br />onte- <br />Ipq$-os9 <br />Number:RHAI <br />P.O. g: <br />Address: <br />Global ID: <br />Sampled By. <br />a <br />J <br />!� <br />Y <br />V <br />Report To: <br />- <br />Email: <br />Ic- <br />Address: <br />Phone: <br />!� _ <br />Fax: <br />Sample ID <br />Sampling <br />Date <br />sampling <br />Time 124 <br />hr) <br />Matrix <br />Sample <br />Type <br />�Pres.^ <br />Cont. <br />No. <br />Cont. <br />Size Initials <br />V <br />Jaz <br />6 <br />7 <br />9 <br />9 <br />10 <br />Signature <br />Print Name Company / Tlt le <br />Date / Time <br />'Relinquished By: <br />; <br />A <br />' Received By: <br />LO w <br />t Ir y (z 1 v t -7 <br />2 Relinquished By: <br />2 Received By: <br />3 Relinquished By: <br />3 Received By: <br />